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A separate problem is the treatment of hypertension in patients with COVID-19. The presence of a history of hypertension in patients with COVID-19 was associated with a more severe course of infection, in contrast to patients who did not have hypertension. According to modern concepts, during the COVID-19 pandemic, patients with hypertension should carefully monitor their blood pressure levels and take constantly prescribed medications. This also applies to the use of so-called blockers of the renin-angiotensin system for the treatment of patients with hypertension: angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers. A number of recent studies show that these groups of drugs not only do not increase the risk of infection with the virus, but also significantly improve the course of coronavirus disease.

Ингибиторы JAK ( тофацитиниб и др.) селективно влияют на внутриклеточную сигнальную систему JAK/STAT, опосредующую действие многих цитокинов, участвующих в патогенезе неспецифического язвенного колита. В отличие от генно-инженерных биологических препаратов, ингибиторы янус-киназа представляют собой низкомолекулярные синтетические средства, предназначенные для перорального приема. Тофацитиниб рекомендуют назначать пациентам с тяжелым и среднетяжелым течением неспецифического язвенного колита. Ингибиторы JAK могут нарушать вирусный иммунитет. Рекомендуется использовать низкую эффективную дозу для поддержания ремиссии: по возможности 5 мг, вместо 10 мг, два раза в день. Избегайте применения тофацитиниба во время пандемии, если нет других альтернатив. Это позволит пациентам избежать возможных побочных эффектов и частого наблюдения за патологией.

Moreover, low vitamin D levels common in patients with CVD may increase the risk and severity of COVID-19. This is because vitamin D increases levels of anti-inflammatory cytokines and reduces viral replication, which in turn can reduce pro-inflammatory cytokines that contribute to lung damage. Despite the lack of evidence demonstrating increased susceptibility to COVID-19, drugs used in the treatment of COPD increase the risk of respiratory tract infections to varying degrees. However, theoretically, some immunosuppressive drugs may have beneficial effects, given that the cause of death in COVID-19 is a cytokine storm leading to acute respiratory failure.

The use of thiopurine (azathioprine and mercaptopurine) reduces the immune response to viruses, which is associated with an increased risk of opportunistic infections. There is limited evidence that they increase the risk of respiratory infections. The risks and benefits should be considered, but most patients can continue on a stable dose. In patients in stable remission, elderly patients and in the presence of concomitant pathology, it is recommended to stop taking thiopurine. During a pandemic, it is recommended to avoid starting thiopurine or increasing the dose, which will allow patients to avoid potential side effects. If the patient is in contact with a COVID-19 person, temporary withdrawal of thiopurine for 2 weeks should be considered. If a patient tests positive for SARS-CoV-2 and/or develops COVID-19, temporary discontinuation of thiopurine may be recommended until the patient clears the infection.

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